Insurers could soon see CMS rule meant to stabilize individual market
As soon as this week, a rule submitted by the Trump administration with the goal of stabilizing the individual marketplace could be made public.
The Office of Management and Budget late last week began reviewing a rule listed as “economically significant,” which means it would have an annual effect on the economy of at least $100 million.
The rule was submitted to the OMB the same day that the Senate Health, Education, Labor and Pensions Committee heard testimony from insurers who said immediate action was needed to ensure the viability of the marketplace. They asked that subsidies continue to allow individuals to purchase plans for the next two or three years. They also want full federal reinsurance payments for 2016. The pool of money was supposed to be paid to insurers that covered higher-risk patients.
Edmund Haislmaier, a senior research fellow at the Heritage Foundation who worked on President Donald Trump’s transition team on health policy matters, has not seen the rule but believes it aims to tighten eligibility standards for marketplace coverage and would make it harder for people to get coverage during a special enrollment period. Insurers say both issues would discourage people from signing up when they realize they need costly medical services and then dropping coverage after they receive care.
The OMB has up to 90 days to review the proposal. Once a review is completed, it’s sent back to the agency that submitted it, which in this case is the CMS. The agency has historically posted a rule either the same day an OMB review ended or the next business day.